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FOR YOUR PROTECTION

* Sign each Cheque (in upper left-hand corner) immediately upon purchase. You are not protected in case of loss or theft until each Cheque is so signed.

* Countersign your Cheques (in lower left-hand corner) only in presence of person accepting them.

* Handle and safeguard Cheques as you would cash.

* Keep Cheques with you, or in a safe place, at all times - never leave them in your hotel room, luggage or glove compartment of car.

* Carry Cheques in your most secure inside breast pocket of coat or jacket ... or in zippered compartment of handbag,

* Carry this Record Slip separately from wallet of Cheques. In addition, send a memorandum of serial numbers to your home or other address for safekeeping, should both Cheques and this Record Slip be lost or destroyed.

* Notify nearest American Express office immediately if Cheques are lost or stolen. To obtain prompt refund - see reverse side.

[[6 columned table]]
|           |              |        |    CHEQUES NUMBERED            |
| QUANTITY  | DENOMINATION | AMOUNT | SERIES   | FROM     | TO-INCL. |
|           | $10          |        |          |          |          |
| 2         | $20.         | 40     | JA       | 23346.192|  793     |
| 4         | $50          | 200    | UA       | 21527.605|  608    
|           | $100         |        |          |          |          |        |           | $500 
|           | TOTAL        | 240    | Date      19       
               
PURCHASER'S COPY

Transcription Notes:
Receipt for travelers checks; series and check numbers somewhat illegible.